Laser Cataract Surgery

How Laser is Safer in General

Outcomes study between Femtosecond laser-assisted cataract surgery and conventional phacoemulsification surgery using an active fluidics system

Clin Ophthalmol. 2017 Sep 25;11:1735-1739. doi: 10.2147/OPTH.S136136. eCollection 2017


PURPOSE: The purpose of this study was to compare intraoperative parameters between femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification using Centurion® Vision System with Active Fluidics.


CONCLUSION: FLACS with Active Fluidics System can reduce the ultrasound energy use during cataract surgery, in spite of increasing case time, fluid usage and ASP (aspiration) time


Layman's Interpretation: By using Laser Assisted Cataract Surgery you reduce the energy going into the eye which translates to less damage to the cornea and eye and improved outcomes.


Why Laser Saves Cornea Tissue

Comparison of Corneal Endothelial Cell Loss Between Two Femtosecond Laser Platforms and Standard Phacoemulsification

J Refract Surg. 2017 Oct 1;33(10):708-712. doi: 10.3928/1081597X-20170731-01.

PURPOSE: To analyze and compare the changes in endothelial cell density (ECD) and cumulative dissipated energy (CDE) in patients having cataract surgery with two different femtosecond laser platforms and standard phacoemulsification.


CONCLUSION: FLACS pretreatment resulted in a decrease in CDE and less endothelial cell loss when compared to standard phacoemulsification. The decrease in endothelial cell loss was more prominent in the denser cataract group; thus, FLACS may be most beneficial in those cases. There was no significant difference in results between the two laser platforms. [J Refract Surg. 2017;33(10):708-712.]. 


Layman's Interpretation: By using Laser Assisted Cataract Surgery techniques, with either of the two types of machines, the cornea remains healthier after surgery. The cornea has a limited number of cells that are not regenerated and excessive loss leads to corneal transplants. 

Reduction of Serious Complications Among Surgeons

Comparison of vitreous loss rates between manual phacoemulsification and femtosecond laser-assisted cataract surgery. 

J Cataract Refract Surg. 2016 Jul;42(7):1003-8. doi: 10.1016/j.jcrs.2016.04.027 


PURPOSE: To compare the vitreous loss complication rate of manual phacoemulsification cataract surgery with that of femtosecond laser-assisted cataract surgery. 


RESULTS: Of the total 7155 cases from 2010 to 2014, 3784 were consecutively performed using manual phacoemulsification from 2010 to 2012 and 3371 were performed using femtosecond laser-assisted cataract surgery from 2013 to 2014. The rate of vitreous loss with exclusions was 1.17% in the manual phacoemulsification group and versus 0.65% femtosecond laser-assisted group; without exclusions, the rate was 1.40% versus 0.77%. In absolute terms, the rate decreased for every surgeon in the study.


Layman's Interpretation: By having cataract surgery by Laser Assist, one of the most serious complication rates that can lead to permanent and irreversible vision loss is reduced by almost 50%. This reduction was for every surgeon in the study, meaning that all surgeons outcomes were better with laser. Nobody is immune. This has a serious implication on the safety of cataract surgery and laser should be considered for all cataract surgery.


The research here is very significant and when considering laser assisted cataract surgery, if affordable, it should be done with every case. In not doing so, the complication rates for one of the most potentially vision threatening complication is reduced by 50% among all surgeons studied. Secondly, the risk of corneal transplant is reduced in patients having laser assisted cataract surgery.